Individual provider Active NPI

Stewart P Atkins, P.T.

  • Physical Therapist
  • Tuscaloosa, AL
National Provider Identifier
1518962471
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH2884 Issued in AL
Practice address
1110 15TH St
Ste C
Tuscaloosa, AL 35401-3393
Phone
(205) 758-0053
Fax
(205) 758-0390
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT3590 MS
Physical Therapist 225100000X PTH2884 AL Primary

Addresses

Primary practice location

1110 15TH St
Ste C
Tuscaloosa, AL 35401-3393

Mailing address

1110 15TH St
Ste C
Tuscaloosa, AL 35401-3393
Phone (205) 758-0053

Other identifiers 3

IdentifierTypeStateIssuer
51505241MedicaidAL
04323710MedicaidMS
51505241OtherALBCBS OF AL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100729000063 MS Practitioner - Physical Therapist in Private Practice 3173656071
I20150817001515 AL Practitioner - Physical Therapist in Private Practice 3173656071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1110 15TH St
Suite C
Tuscaloosa, AL 35401-3393
Phone (205) 758-0053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH2884ALMDPhysical Therapist
PT3590MSMDPhysical Therapist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518962471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 15TH ST",
            "address_2": "STE C",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354013393",
            "telephone_number": "205-758-0053",
            "fax_number": "205-758-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 15TH ST",
            "address_2": "STE C",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354013393",
            "telephone_number": "205-758-0053",
            "fax_number": "205-758-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATKINS",
        "first_name": "STEWART",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT3590",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH2884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51505241",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04323710",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL",
            "identifier": "51505241",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.